Although she managed to avoid both of the big Christchurch earthquakes, her work in the days after has seen Tracy McCowan awarded with a special Canterbury Earthquake Citation.

An intensive care paramedic, Tracy works four days on, four days off, in a job-share position with a colleague in Christchurch. She considers herself very lucky to have avoided the big quakes; they happened on her rostered days off, which she spends at home in Kaikoura. But she was still very much a part of the emergency teams that responded to the many callouts after February's disaster.

While Tracy insists she did nothing out of the ordinary, the citation recognises the hard work and dedication of many St John personnel in one of the most challenging times for the organisation in recent history.

In his covering letter, St John South Island general manager David Thomas commends those, including Tracy, for their sense of camaraderie and the strength they gave to the people of Christchurch, despite having their own issues to deal with.

"My colleagues definitely bore the brunt of it," Tracy said.

"They had been affected by the earthquake with their houses damaged and so on. And with communications down, many lost contact with their families, so I did feel for them . . . I take my hat off to them all."

Tracy said she is not a drama queen by any stretch of the imagination. In fact, in her role she tends to keep her head more than most and, if anything, play things down in an emergency. But even she admits to being rattled, albeit subconsciously, by the aftershocks.

"When they start you never know how strong they are going to be or how long they are going to last. You may not be aware you are startled by them but subconsciously your body must be expecting it. When you hear a rumble it might just be a lorry going past but your heart always goes for a bit of a race."

And of course the nature of an already tough job got a lot tougher with all that Christchurch was having to deal with. Blocked roads, dust and liquefaction all added up to extra pressure, as well as the fact that many St John staff who were brought in from outside the district were not familiar with the area. People had to work wearing masks and glasses because of the amount of dust.

Working out of a tent with a generator was somewhat unusual too but she and the rest of the team were very well looked after, she said.

As for the callouts themselves, there was an increase in chest pains, heart attacks and anxiety; not surprising, said Tracy, when you look at what some people had gone through. Then there were the assaults which again could be attributed to an increase in stress. And everyone in Christchurch seemed to have a cough, probably on account of the amount of dust and liquefaction around.

Looking back, Tracy's biggest disappointment is seeing how much flak people are getting throughout the subsequent investigations.

"At the time you do what you feel is appropriate. Everyone was doing their very best in the circumstances. No matter how many scenarios you go through, nobody could ever plan for anything like that magnitude. Especially two of them."